Living with the Lump

When I was diagnosed with breast cancer in the spring of 2005, there was no lump. I had a widespread case of DCIS, which my surgeon informed me was like “looking for salt in a mound of mashed potatoes.”

In fact I confess, that despite all the education out there . . . . thank you Susan G. Komen, the reminders in my ob/gyn offices to perform monthly breast exams, and the you can’t avoid it Pink Ribbon campaigns everywhere in October, I have never performed a full breast exam on myself, because the fact is I am terrified that one day, I will find one . . . a lump that is.

And so I depend on my husband, who knows my breasts better than I to perform this exam for me. And he does so with tenderness and great respect for this tissue which nourished five children.

I have never had a lump. Thank God. I hope I never do. So I cannot imagine the terror when Pink Fund Blogger Amy Rauch Nielson found her second lump and learned it could not just be surgically removed, but instead shrunk.

In the meantime, she is learning to live with the lump. Here’s how she feels:

Last time is so different from this time.

The first time I was diagnosed with breast cancer was in March 2006. I was a Stage 1; the lump was the size of a blueberry and extensive testing, including a Sentinel Node biopsy, showed that, thank God, the lump was contained to my left breast.

I had a protocol of treatment that felt intuitive. It was through a lumpectomy on March 3, 2006 and the subsequent biopsy results that the margins around my tumor were declared “clear.”

Still, because I am BRCA 1 positive and the likelihood of a new primary was statistically quite high, I opted for a double mastectomy on April 14, 2006. Then, as “insurance” against the possibility that there was a rogue cell or two lying in wait someplace in my body, I opted for the recommended four doses of chemotherapy

I began my protocol of Adriamycin and Cytoxan on May 31, 2006. I was done by July 28, 2006. I knew I would be. My schedule was pre-set – every third Tuesday, four chemotherapy treatments total. I could count the days, cross them off on the calendar, feel myself getting closer and closer to the end of treatment and the beginning of my new, cancer-free life. But best of all, I knew that the cancer was gone from my body and that all of the additional treatments I was undergoing were “just to make sure.”

This time around is so counter-intuitive. I’m not saying that the treatment I’m on is anything but what it should be. It definitely IS as it should be and I am grateful to have it. The protocol just feels odd and takes some getting used to.

Because I was diagnosed as a Stage 4 this past January, with metastasis in my breast lymph nodes and both my lungs, chemotherapy comes first, surgery later. I understand the logic. First we treat and get rid of the metastatic breast cancer in my nodes and lungs, because that’s where the true danger lies — in its ability to continue on and even spread. Then we go for the lump in my breast.

Neoadjuvant Chemotherapy

This approach, I’ve learned, is called neoadjuvant chemotherapy – chemotherapy that is given before surgery to help shrink the tumor(s) before removal. Once we’re “down to the last tumor,” – which will likely and hopefully be the one in my left breast that started this whole thing – the surgeon will go in, remove my left breast implant, and get rid of that lump. Then, I’ll go through a series of radiation treatments to make sure we got every last cell

That’s when the lump in my left breast will be gone for sure. And I’m so looking forward to that day. Because even though I understand the course of my treatment, it is psychologically difficult to walk around with a lump in your breast every day, knowing full well that this hard tumor the size of a shooter marble is cancer.